MARC A BELLAZZINI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

MARC

Middle

Last Name

BELLAZZINI

Suffix

Business Name

MARC A BELLAZZINI MD

Original Issue Date

09/10/1999

Effective Date

09/10/1999

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006